Saturday, May 12, 2012

What the brain tells us

In the past 20 years, neuroscience, buoyed by advances in imaging technology—namely, functional magnetic resonance imaging or fMRI—has been giving us a cranial roadmap into our behavior, extreme and otherwise. As the technology keeps improving at a dramatic pace, so can the development of treatments for diseases, some of which couldn't even be diagnosed until after death.

Last week yielded some amazing reports on brain research, from diagnosing injury before the symptoms manifest to tracking emotional behavior to specific little gray cells. Here are just a few:

The serious consequences of a blow to the head, and a possible test. Most people know the insidious consequences of a knockout or a concussion, the worst case scenario being a blood clot that leads to a stroke. Less understood are consequences of blows to the head—direct or percussive, like from being too near an explosive device—that leave you reeling, but conscious. If you're not out cold, the layman reasoning goes, you're OK.

But as NFL helmet lawsuits, post-traumatic stress disorders (PTSD) in veterans, and the living example of Muhammed Ali show, there are long-term consequences to repeated knocks. The Center for the Study of Traumatic Encephalopathy, which focuses on progressive degenerative brain disease, points out that this has been recognized in boxers since the 1920s. Unfortunately, diagnoses don't happen until literally long after damage has been done.

However, a project launched last year in Nevada—the Professional Fighters Brain Clinical Research Study—has looked into the gray matter of more than 100 mixed martial artists and boxers with compelling results already: MRI scans might reveal injuries beforesymptoms show.

The physical changes, detected by MRI scans, are a reduction in size in the hippocampus and thalamus of the brains of fighters with more than six years in the ring. These parts of the brain deal with such functions as memory and alertness. While those who had fought for more than six years did not exhibit any declines in cognitive function, fighters with more than 12 years in the ring did. Thus, Dr. Bernick's group concluded, the lag between detectability and physical symptoms probably occurs sometime during those six years. (April 24, The New York Times)

This could have far-reaching repercussions for disorders like Alzheimer's or PSTD, especially given our burgeoning veteran population, 30% of which have been diagnosed with PSTD, brain injuries, or depression. Connecting such problems with physical injury might also help alleviate the stigma surrounding them.

[T]he increased military and media attention given to post-traumatic stress disorder and traumatic brain injury has had the effect of stigmatizing veterans, advocates say. Some employers fear that soldiers diagnosed with these conditions are prone to violence or instability. (April 25, The Los Angeles Times)

Finding how to stop extreme behavior. Thanks to crime literature and serial killer movies, Americans are aware of many different "-paths": sociopath, psychopath, and antisocial personality disorder. What has been a raging debate is if one is doomed to that diagnosis and basically lifetime incarceration, or if there's a window of intervention. One researcher went on a roadtrip into the heart of darkness: Using a mobile MRI unit, a University of New Mexico associate professor of psychology took a snapshot of 2,000 inmate volunteers.

He found that compared to the average offender, 60 percent of psychopaths re-offend within the next 200 days. Maximum-security juveniles showed a similar pattern: 68 percent of individuals who were at high risk for psychopathy re-offended.

Using images of the brain, [Kent] Kiehl said he could predict psychopathy as well as one can with clinical error. (April 23, Duke (University) Research Blog)

Among preliminary findings, Kiehl zeroed in on the interaction with a gene (MAOA) and a "stressful" upbringing and that treatment like group therapy actually ends in "violent failure" among adults. For juveniles, intervention's a different story and can show a 50% reduction in violent recidivism.

"We have a problem in the United States: We incarcerate a lot of people," he said. "We incarcerate more per capita than any other country. It's expensive—it costs $2.34 trillion per year, which is about the same as the annual estimate for all health care [in the country]." (April 23, Duke (University) Research Blog)